Objective: Many of the elderly patients are suffering from constipation, are using the oral laxative.  However the risk assessment of the oral laxative is not performed.  Therefore, we used Japanese Adverse Drug Event Report database (JADER) and examined for the safety of the oral laxative in the elderly patients.
Methods: Since the analysis target medicines; 12 oral laxatives and target ADEs; “digestive disorders” and “electrolyte abnormality,” the JADER database for April 2004 to January 2015 were analyzed in adults of age exceeds 60.  We used the reporting odds ratio for a safety index of drugs, using reporting odds ratio, when the Lower bound of the 95% two-sided confidence interval exceeds 1, it is the signal detection of ADE.
Results: The oral laxatives detected the signal of “digestive disorders” were three medicines, and “electrolyte abnormality” were five medicines.  Especially, for electrolyte abnormalities not only increases the blood magnesium values as magnesium oxide, that there is also affect other electrolyte revealed.
Conclusion: Some oral laxatives were also intended to signal detections of the adverse events that are not listed in the attached document, it is necessary to pay attention to the use of them for the elderly patients.

Objective: Elderly patients commonly experience adverse drug events (ADEs) owing to their poor drug metabolizing and excretion ability, and these often cause multiple organ dysfunction syndrome.  Therefore, it is important that we identify the adverse drug events early on during prognosis.  We searched for oral medicines that might exacerbate the prognosis of ADEs in elderly patients.
Methods: The objects under analysis were oral medicines that were registered in the Japanese Adverse Drug Event Report database (JADER).  The associations between the elderly/non-elderly patients and exacerbation risk/non-exacerbation risk were analyzed by risk ratios (RR).  The signal detection of exacerbation risk was defined as 95% confidence interval of lower limit of risk ratio>1 and χ²≥4.
Results: The oral medicines that might markedly exacerbate the prognosis of ADEs in the elderly patients in comparison with the ADEs of young patients included 84 items, of which 63 have not been described as potentially inappropriate medicines in all guidelines for medical treatment of the elderly patients.
Conclusion: In this study, while we could not search for oral medicines having a high risk of ADEs, we were able to search for oral medicines that might exacerbate the prognosis of ADEs in elderly patients.  This result could contribute to the proper use of medicines in the elderly patients.

Background: In May 2023, Japan reclassified coronavirus disease 2019 (COVID-19) under the Infectious Disease Control Law. However, there have been insufficient examinations on how the change in classification has impacted citizens’ lives. This study examined the impact of revisions to the Infectious Disease Control Law in Japan on the social frailty and social life of older adults in the community. Methods: From mid-March to mid-April 2023, a self-administered survey targeting community-dwelling older adults aged 65 years and over was conducted by mail, before the revision of the Infectious Disease Control Law. From mid-February to mid-March 2024, after the revision of the law, a second survey was conducted among those who had responded to the first one. Ultimately, data from 240 cases were collected. The survey included social information such as mask-wearing when going out, status of long-term care insurance, presence of polypharmacy, sleep status, long outings, presence of COVID-19 infection, presence of post-COVID-19 syndrome (if infected), social frailty, and the Kihon Checklist, alongside basic demographic information. Results: After the revision of the Infectious Disease Control Law, there was an increase in the number of individuals receiving benefits from long-term care insurance and those identified as socially frail. However, no significant differences were observed in the other surveyed items. Conclusion The increase in socially frail individuals and those with long-term care insurance suggests that, despite the revision of the Infectious Disease Control Law, the connections within the local community that had once weakened due to the COVID-19 pandemic have not been fully restored.

Background: Phase angle, which is associated with cellular health, has attracted attention as a noninvasive and objective method for nutritional assessment. However, the association between malnutrition and phase angle in older inpatients with hip fractures has not been reported. Therefore, this study investigated this association in older inpatients (aged ≥65 years) with hip fractures and determined the cutoff phase angle for determining malnutrition. Methods: This cross-sectional study retrospectively analyzed the data of 96 inpatients with hip fractures who were hospitalized in rehabilitation units after surgery (male, 29.4%; mean age, 82.4±6.2 years). Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), with malnutrition defined as a GNRI ≥98. Bioelectrical impedance analysis was used to measure phase angles. Results: The phase angle was associated with malnutrition (B=−1.173; odds ratio=0.310; 95% confidence interval 0.58–0.83; p=0.015). The area under the receiver operating characteristic curve was 0.71. The cutoff phase angle for malnutrition was 3.96° (sensitivity=0.85, specificity=0.63). Conclusion Phase angle could be an indicator of malnutrition in older inpatients with hip fractures. Our findings will help formulate rehabilitation strategies for these patients.

Background: In May 2023, Japan reclassified coronavirus disease 2019 (COVID-19) under the Infectious Disease Control Law. However, there have been insufficient examinations on how the change in classification has impacted citizens’ lives. This study examined the impact of revisions to the Infectious Disease Control Law in Japan on the social frailty and social life of older adults in the community. Methods: From mid-March to mid-April 2023, a self-administered survey targeting community-dwelling older adults aged 65 years and over was conducted by mail, before the revision of the Infectious Disease Control Law. From mid-February to mid-March 2024, after the revision of the law, a second survey was conducted among those who had responded to the first one. Ultimately, data from 240 cases were collected. The survey included social information such as mask-wearing when going out, status of long-term care insurance, presence of polypharmacy, sleep status, long outings, presence of COVID-19 infection, presence of post-COVID-19 syndrome (if infected), social frailty, and the Kihon Checklist, alongside basic demographic information. Results: After the revision of the Infectious Disease Control Law, there was an increase in the number of individuals receiving benefits from long-term care insurance and those identified as socially frail. However, no significant differences were observed in the other surveyed items. Conclusion The increase in socially frail individuals and those with long-term care insurance suggests that, despite the revision of the Infectious Disease Control Law, the connections within the local community that had once weakened due to the COVID-19 pandemic have not been fully restored.

Background: In May 2023, Japan reclassified coronavirus disease 2019 (COVID-19) under the Infectious Disease Control Law. However, there have been insufficient examinations on how the change in classification has impacted citizens’ lives. This study examined the impact of revisions to the Infectious Disease Control Law in Japan on the social frailty and social life of older adults in the community. Methods: From mid-March to mid-April 2023, a self-administered survey targeting community-dwelling older adults aged 65 years and over was conducted by mail, before the revision of the Infectious Disease Control Law. From mid-February to mid-March 2024, after the revision of the law, a second survey was conducted among those who had responded to the first one. Ultimately, data from 240 cases were collected. The survey included social information such as mask-wearing when going out, status of long-term care insurance, presence of polypharmacy, sleep status, long outings, presence of COVID-19 infection, presence of post-COVID-19 syndrome (if infected), social frailty, and the Kihon Checklist, alongside basic demographic information. Results: After the revision of the Infectious Disease Control Law, there was an increase in the number of individuals receiving benefits from long-term care insurance and those identified as socially frail. However, no significant differences were observed in the other surveyed items. Conclusion The increase in socially frail individuals and those with long-term care insurance suggests that, despite the revision of the Infectious Disease Control Law, the connections within the local community that had once weakened due to the COVID-19 pandemic have not been fully restored.

Along with clinical practice and education, research is among the most important activities for medical doctors. The same is true in cardiovascular surgery: Young cardiovascular surgeons are expected to improve their surgical techniques and prioritize their clinical practice. However, their perspective on the role of research in their field of expertise is unknown. Therefore, we conducted a survey of and discussion with young cardiovascular surgeons to clarify their thoughts and concerns about performing research. Here we review and report the survey and discussion results.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.